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HomeMy WebLinkAbout2014_07_17 Form 410 Initial - Emily Lo Statement of Organization Date Stamp A Recipient Committee ' 0 * A I Statement Type Initial El Amendment El Termination—See Part 5 EForOfffif'iciial Use Only Not yet qualified X or List I.D.number: List I.D.number: # # JUL 17 2014 Date qualified as committee Date qualified as committee Date of Termination (If applicable) ............... NAME OFCOMMITTEENAME OF TREASURER Re-d'o ct-C-;�/ elfrlt'-14" OARADA STREET ADDRESS(NO P.O.BOX) V STREET ADDRESS(NO P.O.BOX) ?? - CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE 5A,6,47V67/ MAILING ADDRESS F DIFFERENT) NAME OF ASSISTANT TREAIURER,IF ANY at Xfp?p FAX/E-MAIL ADDRESS STREET ADDRESS(NO P.O.BOX) (? COMMITTEE IS ACTIVE CITY STATE ZIP CODE AREA CODE/PHONE NAME OF PRINCIPAL OFFICER(S) Attach additional information on appropriately labeled continuation sheets. STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE I have used all reasonable diligence preparing thisstatement and to the best of my knowledge the formatioion contained he ein is truend comp e. cer y un er penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on By DA E SIGNATURE OF TREASURER OR ASSISTANT TREASURER Executed on ?Z—/ By 0-6de- DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT FPPC Form 410(Dec/2012) FPPC Advice:adviceWppic.ca.gov(866/275-3772) www.fppc.ca.gov Statement of Organization CALIFORNIA Recipient Committee _ M 410 INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D.NUMBER • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER ADDRESS CITY STATE ZIP CODE C4 Controlled _. • List the name of each controlling officeholder,candidate,or state measure proponent. If candidate or officeholder controlled,also list the elective office sought or held,and district number,if any,and the year of the election. • List the political party with which each officeholder or candidate is affiliated or check"nonpartisan." • If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee. ELECTIVE OFFICE SOUGHT OR HELD NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUUD7LgIG1 E DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY \ s ell-t'f"�-'t Nonpartisan l..v / ❑ Nonpartisan Primarily Formed Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S)NAME OR MEASURE(S)FULL TITLE(INCLUDE BALLOT NO.OR LETTER) CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION (INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK ONE SUPPORT OPPOSE ❑ ❑ Surn OPPOSE FPPC Form 410(Dec/2012) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov u Statement of Organization CALIFORNIA Recipient Committee _ M 410 INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME I.D.NUMBER General •• Not formed to support or oppose specific candidates or measures in a single election. Check only one box: ❑ CITY Committee ❑ COUNTY Committee❑ STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY •• List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STR EET ADDR ESS NO.AND STREET CITY STATE ZIP CODE Small • • •r Committee ❑ Date qualified • This committee has ceased to receive contributions and make expenditures; • This committee does not anticipate receiving contributions or making expenditures in the future; • This committee has eliminated or has no intention or ability to discharge all debts,loans received,and other obligations; • This committee has no surplus funds;and • This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions. -- There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government Code Section 89519. -- Leftover funds of ballot measure committees may be used for political,legislative or governmental purposes under Government Code Sections 89511-89518,and are. subject to Elections Code Section 18680 and FPPC Regulation 18521.5. FPPC Form 410(Dec/2012) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov